[Factors associated with quality of life for patients with post-stroke aphasia in the Cotonou hospitals, Benin]. / Facteurs associes a la qualite de vie des aphasiques post accident vasculaire cerebral en milieu hospitalier a cotonou, Benin.

INTRODUCTION: The objective of this study was to determine the factors influencing quality of life for patients with post-stroke aphasia followed in Cotonou hospitals. METHOD: A prospective descriptive and analytical cross-sectional study was conducted in CNHU-HKM (Cotonou, Benin) from October to December 2012; focusing on patients with at least six months of post-stroke aphasia. For each patient, a SIP-65 questionnaire was administered. The Epi Info 3.5 software was used for data analysis. A multivariate analysis was performed to determine factors associated with quality of life for patients with aphasia. RESULTS: In total, 41 patients were included in this study with a sex ratio of 1.3. The average age was 55.3 ± 2.5 years. The average duration of the aphasia was 10 months. Broca's aphasia was predominant (68.3%). 60.8% of aphasia patients were able to preserve their quality of life. Multivariate analysis showed that age, family support, the type of stroke and aphasia and speech therapy were associated with quality of life. CONCLUSION: The treatment of post-stroke aphasia must incorporate these factors associated with quality of life for a better recovery of patients.

INTRODUCTION: L'objectif de ce travail était de déterminer les facteurs influençant la qualité de vie des patients aphasiques post-AVC suivis à Cotonou. MÉTHODE: Il s'agit d'une étude transversale, prospective descriptive et analytique qui s'est déroulée au CNHU-HKM de Cotonou d'Octobre à Décembre 2012; elle a inclus les patients aphasiques post-AVC d'au moins six mois. Pour chaque patient, un questionnaire SIP-65 a été administré. Le logiciel Epi info 3.5 a servi de base à l'analyse des données. Une analyse multivariée a été effectuée pour déterminer les facteurs associés à la qualité de vie des aphasiques. RÉSULTATS: Au total, 41 patients ont été inclus dans l'étude avec une sex-ratio de 1,3. L'âge moyen était de 55,3 ± 2,5 ans. La durée moyenne d'évolution de l'aphasie était 10 mois. L'aphasie de Broca était prédominante (68,3%). 60,8% des aphasiques avaient une qualité de vie préservée. L'analyse multivariée a montré que l'âge, le soutien de la famille, le type d'AVC et d'aphasie et le traitement orthophonique étaient associés à la qualité de vie. CONCLUSION: La prise en charge des aphasiques post-AVC doit intégrer ces facteurs associés à la qualité de vie pour une meilleure récupération des patients.

Facteurs associés à la qualité de vie des aphasiques post-accident vasculaire cérébral en milieu hospitalier à Cotonou, Bénin

L'objectif de ce travail était de déterminer les facteurs influençant la qualité de vie des patients aphasiques post-AVC suivis à Cotonou. Méthode : Il s'agit d'une étude transversale, prospective descriptive et analytique qui s'est déroulée au CNHU-HKM de Cotonou d'Octobre à Décembre 2012 ; elle a inclus les patients aphasiques post-AVC d'au moins six mois. Pour chaque patient, un questionnaire SIP-65 a été administré. Le logiciel Epi info 3.5 a servi de base à l'analyse des données. Une analyse multivariée a été effectuée pour déterminer les facteurs associés à la qualité de vie des aphasiques. Résultats : Au total, 41 patients ont été inclus dans l'étude avec une sex-ratio de 1,3. L'âge moyen était de 55,3 ± 2,5 ans. La durée moyenne d'évolution de l'aphasie était 10 mois. L'aphasie de Broca était prédominante (68,3%). 60,8% des aphasiques avaient une qualité de vie préservée. L'analyse multivariée a montré que l'âge, le soutien de la famille, le type d'AVC et d'aphasie et le traitement orthophonique étaient associés à la qualité de vie. Conclusion : La prise en charge des aphasiques post-AVC doit intégrer ces facteurs associés à la qualité de vie pour une meilleure récupération des patients

[Contribution of vascular ultrasonography in patients with ischemic strokes in Brazzaville (Congo)]. / Apport de l'écho-Doppler vasculaire dans les infarctus cérébraux à Brazzaville (Congo).

OBJECTIVE: To determine the prevalence of the carotid lesions during ischemic strokes. METHODS: This was a descriptive cross-sectional study, conducted in Brazzaville from January 2011 to June 2012 in a consecutive series of 73 patients, victims of a transient ischemic attack or ischemic stroke, documented by a brain computed tomography. All patients underwent vascular ultrasonography of the supra-aortic trunks, carried out within the framework of etiological assessment. The examination searched for plaques, parietal infiltration (measurement of intima-media thickness), and carotid stenosis or occlusion. RESULTS: There were 49 men (67%) and 24 women (33%), mean age 58.7 ± 11.8 years. Eleven patients (15%) had a transient ischemic attack and 62 (85%) an ischemic stroke. The identified independent vascular risk factors were known and treated hypertension (n=66, 90.4%), dyslipidemia (n=16, 22%), diabetes mellitus (n=9, 12.3%), and smoking (n=5, 6.8%), with on average 2.5 factors per individual. Vascular ultrasonography of the supra-aortic trunks, normal in 44 patients (60.3%) was pathological in the other 29 (39.7%). The main anomalies were atheromatous plaque (n=10, 13.7%), parietal infiltration (n=19, 26%). On average intima-media thickness was 0.86 ± 0.11 mm on the left and 0.83 ± 0.11 mm on the right. Two cases of moderate stenosis were noted on the right and left internal carotids, respectively. CONCLUSION: This preliminary study confirms the existence of carotid atherosclerosis anomalies during ischemic strokes. These lesions, though non-significant, must nevertheless be taken into consideration when searching for the cause of stroke in high-risk vascular patients.

[Gender and stroke in Brazzaville]. / Genre et accidents vasculaires cérébraux à Brazzaville.

BACKGROUND: The relationship between gender and cerebrovascular disease is controversial. The aim of our study was to evaluate the relationship between gender and vascular risk factors, biological variables and the severity of the neurological deficit in stroke. METHODS: This cross-sectional study, conducted from March to August 2011 in the department of neurology of the university hospital of Brazzaville which included all patients hospitalized for confirmed stroke. The study variables were: age, sex, vascular risk factors, NIHSS scores and Glasgow, blood pressure, and the biological exams and complications. Statistical analysis was performed on SPSS12. RESULTS: Eighty patients were included. The mean age was 62.7 ± 11.2 years, with 58.8% of men. Alcohol intake and smoking were more frequent in men than women respectively P=0.005 and P=0.032. Psychosocial stress was more often declared by women than men (P=0.042). However there was no significant difference in biological variables, the severity of stroke and the occurrence of complications CONCLUSION: Our study suggests that in the Congolese context, gender does not influence significantly most parameters during stroke, but men consume more alcohol and women are exposed to psychosocial stress.

[Determinants of cerebral malaria in Congolese children]. / Déterminants du neuropaludisme en milieu pédiatrique congolais.

Malaria still constitutes a worrying problem of public health. It remains an important cause of infant mortality. To determine the determinants of severe malaria a case control study was carried out from July to December 2011 in the pediatric intensive care department of the university hospital of Brazzaville. The group included 230 children hospitalised for severe malaria, and the control group consisted of children followed up for non-severe malaria. Cases and controls were compared using statistical tests for matched group. The young age of the mother (OR=4.13), her poor education level (OR=2.36), the low socioeconomic level of parents (OR=5.90), the malnutrition (OR=2.67), the delay of consultation (OR=13.69) and parasitemia were associated with significantly higher risk of severe malaria. The importance of identified determinants imposes the implementation of primary prevention measures, which pass through the amelioration of socioeconomic and cultural conditions of populations, the reinforcement of sanitary education, and also a secondary prevention consisting of an early and accurate management of ordinary malaria.

[Erectile dysfonction after stroke in Brazzaville]. / Dysfonction érectile après un accident vasculaire cérébral à Brazzaville.

INTRODUCTION: Erectile dysfunction is one of the disability post-stroke the least documented. However, it affects the quality of life, not only the patient but also the couple. OBJECTIVE: The purpose of this work was to study the characteristics of erectile dysfunction after stroke. METHOD: This is a cross-sectional descriptive and analytical data collection survey conducted from February to October 2011, having identified, 104 patients for follow-up post-stroke, seen in outpatient Neurology University Hospital of Brazzaville and in the functional rehabilitation centers. Among them 54 had erectile dysfunction. The parameters studied were: age, marital status, history, vascular risk factors, and the location of the hemiplegic, the etiology of stroke, modified Rankin score and NIHSS. The clinical features and laboratory, the international index of erectile dysfunction (IIEF-5) in its French version. SPSS 12 was used for recording and statistical analysis of data. Chi(2) test was used for comparisons. The significance level was P≤0.05. RESULTS: The frequency of erectile dysfunction after stroke was 51.92%, the average age was 56.32 years. The mean time to onset of erectile dysfunction after stroke was 5 months. The onset was progressive in 70,4%. The hypercholesterolemia was well correlated with the risk of erectile dysfunction (P=0.007) and its severity (P=0,01). Erectile dysfonction was moderate in 61.1% and almost bearable in half the cases. CONCLUSION: Erectile dysfunction post-stroke is common with an impact in the lives of the couple. High cholesterol is an independent risk factor of occurrence of post-stroke.

[Hypertensive emergencies at the University Hospital Center in Brazzaville, Congo]. / Les urgences hypertensives au Centre Hospitalier et Universitaire de Brazzaville (Congo).

The purpose of this retrospective study conducted in the emergency department of the University Hospital Center in Brazzaville, Congo was to determine the prevalence and clinical characteristics of hypertensive emergencies. With a total of 76 patients admitted during the study period, the prevalence of hypertensive emergency was 4%. The sex ratio was 1 and mean patient age was 57.3 years (range, 30 to 80 years). Risk factors included obesity in 62 cases (81.6%), history of hypertension in 65 (85.5%) and low socioeconomic level in 58 (76.3%). Mean delay for consultation was 50 hours (range, 1 to 240 hours). The disease underlying the hypertensive emergency was stroke with 38 cases (50%), heart failure in 20 (26.3%), hypertensive encephalopathy in 11 (14.4%), malignant hypertension in 9 (11.8%), and renal failure in 10 (13.1%). The mean length of emergency treatment was 14.7 hours (range, 5 to 48 hours). Eight deaths (10.5%) occurred during hospitalization in the emergency department.

Motifs d'admission et mortalite du sujet age de 60 ans et plus en reanimation polyvalente du CHU de Brazzaville

Objectifs. Identifier les pathologies et evaluer leur frequence; ainsi que la mortalite des patients ages de plus de 60 ans admis en reanimation. Methodes. Il s'agit d'une etude retrospective realisee au service de reanimation polyvalente du CHU de Brazzaville; entre le 1er janvier et le 31 decembre 2009 et concernant des sujets ages d'au moins 60 ans au moment de leur admission. Resultats. Des 427 admissions dans le service pendant la periode d'etude; 107 ont remplis le critere d'age indique; soit un taux d'hospitalisation de 25. Les sujets du sexe masculin etaient majoritaires (59) et la tranche d'age de 60-70 ans etait la plus representee (63;5). Les causes d'hospitalisation ont ete dominees par les accidents vasculaires cerebraux (31;4). La duree moyenne du sejour etait de 5;8 jours. Les AVC ont represente la principale cause de deces (38) sur les 71 enregistres (taux de mortalite; 66). Conclusion. L'AVC est la cause primordiale de deces au-dela de 60 ans dans notre service. Les axes de prevention et les facteurs favorisants en sont clairement etablis. Des strategies adequates devraient etre vulgarisees au niveau individuel et des decideurs des politiques sanitaires